Lung water assessment: from gravimetry to wearables

Journal of Clinical Monitoring and Computing
Frederic Michard

Abstract

Several techniques are now available to detect and quantify pulmonary edema, from the laboratory postmortem method (gravimetry) to non-invasive wearable sensors. In critically ill patients with adult respiratory distress syndrome (ARDS), computed tomography scans are often performed to visualize lung lesions and quantify lung aeration, but their value seems somewhat limited to quantify pulmonary edema on a routine basis and of course to track changes with therapy. In this context, transpulmonary thermodilution is a convenient technique. It is invasive but most patients with ARDS have a central line and an arterial catheter in place. In addition to extravascular lung water measurements, transpulmonary thermodilution enables the measurement of hemodynamic variables that are useful to guide fluid and diuretic therapy. Echo probes are about to replace the stethoscope in our pocket and, if B lines (aka comet tails) do not allow a real quantification of pulmonary edema, they are useful to detect an increase in lung water. Finally, wireless and wearable sensors are now available to monitor patients on hospital wards and beyond (home monitoring). They should enable the detection of pulmonary congestion at a very early stage, and if com...Continue Reading

References

Jan 1, 1982·Annals of the New York Academy of Sciences·F R LewisJ M Christensen
Nov 9, 2005·Critical Care Medicine·Nicolò PatronitiAntonio Pesenti
Feb 28, 2006·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Eugenio PicanoGaetano Mottola
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Sep 18, 2009·Hemodialysis International·Niloufar KossariPierre Squara
Mar 9, 2013·Chest·Xaime GarcíaMichael R Pinsky
Aug 28, 2016·Journal of Clinical Monitoring and Computing·Frederic Michard
Jun 20, 2017·Critical Care : the Official Journal of the Critical Care Forum·Xavier Monnet, Jean-Louis Teboul

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Citations

Jan 10, 2020·Pediatric Pulmonology·Hai-Feng ZongChuan-Zhong Yang
Jan 26, 2020·Journal of Clinical Monitoring and Computing·D S KarbingM B Jaffe
May 6, 2021·JMIR MHealth and UHealth·Pawel KrzesinskiGrzegorz Gielerak
Oct 27, 2021·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Jui FangYi-Wen Chen

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